Bony Metastasis from Unknown Primary for Orthopaedics Exams

Description

This presentation focuses on metastatic lesions, specifically discussing the diagnostics, treatment options, and the importance of considering underlying malignancies when such lesions are encountered. The speaker begins by thanking the audience for attending and highlights the significance of recognizing metastatic lesions in patients, particularly in those aged 50-65 who present with severe back pain and neurological symptoms. The discussion emphasizes the necessity of thorough diagnostic imaging, particularly MRI, to identify lesions in the vertebrae that may indicate metastasis or infection.



Key points covered include:

- Differentiating metastatic lesions from other potential causes of back pain, such as disk prolapse, especially in individuals with no significant prior history of back pain.

- Common sites of metastasis and how they may manifest in radiological findings, including T2-weighted images that may show destructive lesions in the vertebral bodies.

- The role of a multidisciplinary team (MDT) approach in evaluating and managing suspected malignant lesions, including the importance of histological diagnosis through biopsies to determine the primary source of the metastasis.

- Clinical features of metastatic lesions, such as local tenderness, weakness, pain types, and potential complications like hypercalcemia and coagulopathy.

- Treatment pathways which involve medication for symptom management, palliative care, and surgical intervention when necessary, particularly in cases of neurological compromise due to spinal metastases.

- Surgical considerations including indications for urgent decompression or stabilization, the potential urgency of intervention based on neurological status, and patient prognosis.

- Lastly, the importance of ongoing research and guidelines in the clinical management of metastatic bone disease, highlighting that treatment is highly personalized based on the patient's overall condition and primary cancer status.

Specialties